In order to promote understanding among the custodial staff about suicide related problems, and develop skills in providing first aid in cases of suicide attempts in prisons, on May 18, 2005 the Latvian Centre for Human Rights and Ethnic Studies in cooperation with the Social Rehabilitation Department of the Latvian Prison Services organised a training seminar “Suicide Prevention in Prisons”.

Anhelita Kamenska

The seminar is part of the 3-year project “Monitoring Human Rights and Prevention of Torture in Closed Institutions: Prisons, Police Cells and Mental Heath Care Institutions in Baltic States” funded by the European Commission.

The seminar was attended by 28 participants - custodial staff from Griva, Daugavpils, Matisa, Valmiera, Skirotava, Ilguciems, and Central Prisons, experts and representatives of LCHRES. One of the aims of the seminar was to inform the participants about the “Guidelines for Prison Staff in Dealing with Prisoners Posing Suicide Risk” to assist custodial staff in identifying, assessing suicide risk and in providing help to prisoners, as well as dividing responsibilities among various prison units.

In accordance with the data of the Suicide Prevention Service of the National Mental Health Agency, Latvia remains one of the five world countries with the highest suicide rate. Until mid-May, 2005 suicides and suicide attempts committed in prisons were not included in the official statistics. However, as elsewhere in the world, the suicide and suicide attempt rates are notably higher in prisons than among the general public.

The statistics on the number of suicides – 45 (including 1 juvenile prisoner) - and suicide attempts, including cases of self-harm - 619 (including 117 juveniles) - for 1999-2003 are the first statistics made official by the Latvian Prison Service. However, as noted by a prison staff member during the seminar, the official statistics, especially concerning suicide attempts, may be even higher.

Although the statistics do not provide for a break-down by remand and sentenced prisoners, Central Prison and Liepaja Prison, which are remand prisons, top the prison list in the share of suicides and suicide attempts.

Marina Daliba, representative of the Social Rehabilitation Department of the Latvian Prison Administration conducted the first part of the seminar, during which prison staff members discussed problems related to suicides among prisoners and analysed a suicide case, which had taken place in one of the prisons.

Representatives from the Central Prison explained the high proportion of suicides in their prison by the large number of remand prisoners (the prison holds the largest number of prisoners in Latvia ~ 1,600 prisoners), low staffing levels and lack of psychologists in the prison. The seminar participants argued that, in their experience, prisoners who had taken their lives had not in any way indicated that they were going to commit suicide, which lead to conclude that “hidden suicides” are most widespread suicides among prisoners. However, the large number of prisoners per staff member in most of Latvia’s prisons (80-100 prisoners per 1 staff member) does not ensure normal communication among prisoners and custodial staff, and information about suicide threats by a prisoner may not even reach a staff member.

Seminar participants concluded that most suicide attempts and suicides by prisoners occur in isolation, including while in the disciplinary punishment. Prison staff members drew attention to the lack of information exchange among various institutions, as in most cases custodial staff hardly ever receive any information about previous suicide attempts and other mental health problems faced by the detainee. They also pointed to the fact that, according to their experience, not all suicides attempts (mostly acts of self-harm) should be viewed as “genuine” suicide attempts as it is not infrequent when prisoners try to manipulate prison staff into improving their situation, such as, seeking to be transferred to the prison hospital, not to be placed into a disciplinary punishment cell. Seminar participants analysed a suicide case, which had taken place in one of the prisons and the response of prison staff members to the incident.

Representatives of the Latvian Prison Administration informed the seminar participants about the plans to establish social rehabilitation units with four staff members (psychologists, narcologist, 2 social workers) in 4 prisons (Parlielupe, Ilguciems, Valmiera, Griva) within the EC Equal Project, while the Latvian Prison Administration plans to allocate two psychologist posts in Jelgava and Daugavpils Prisons to work with prisoners sentenced to life imprisonment.

Dr S.Villere of the Centre for Disaster Emergency Medical Services informed the seminar participants about the experience of ambulance services in responding to emergency calls concerning suicide attempts in prisons and police detention cells. She called upon the participants to provide clear information that a suicide attempt has occurred, and not that “somebody became sick,” or the “reason is unknown,” as it determines the choice of ambulance unit that is being sent to the facility, where to wait for the ambulance service to ensure speedy access to the facility, etc. S.Villere informed about the reactions of a human body after a suicide attempt and, with the help of a dummy demonstrated how to perform resuscitation and avoid causing injuries to the neck when a suicide attempt by hanging has occurred, as hanging is the most widespread type of suicide in prisons.

Ilze Gerharde, head of the Suicide Prevention Service of the National Mental Health Agency, who works with clients who have attempted suicide and have been hospitalised, commented the experience of the custodial staff in cases of suicides, suicide and self-harm attempts. She indicated that a closed environment (a prison, a hospital) provokes conflict, and the transfer of a prisoner from a prison cell into a disciplinary punishment cell means that a person has ended into an even more closed environment. She emphasised that serious attention should always be paid to all suicide attempts whether they appear “genuine” or “manipulative” suicide attempts or self-harm as persons who attempt suicide or self-harm never know when they will succeed and when not. The expert indicated that a suicide attempt or a suicide always affects a minimum of 6-7 persons, including prison staff members and called for psychological counselling to be offered also to prison staff members.

LCHRES researcher Anhelita Kamenska gave an overview on the WHO guidelines for prison officers on suicide prevention among prisoners, standards relating to suicide prevention developed by the European Committee for the Prevention of Torture, and suicide prevention policies adopted by various prison systems in the world (USA, UK, and Australia). She also informed the participants about the standards in preventing and investigating deaths under Article 2 (the right to life) of the European Human Rights Convention, making special emphasis on the criteria of effective investigation.